Two Cases of Chloromethylisothiazolinone and Methylisothiazolinone-associated Toxic Lung Injury
Previous animal studies have not conclusively determined the association between exposure to humidifier disinfectants (HDs) containing 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and/or 2-methyl-4-isothiazolin-3-one (MIT) and development of HD-associated lung injuries. Nonetheless, patients expose...
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| Published in | Journal of Korean medical science Vol. 33; no. 16; pp. e119 - 8 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
The Korean Academy of Medical Sciences
16.04.2018
대한의학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1011-8934 1598-6357 1598-6357 |
| DOI | 10.3346/jkms.2018.33.e119 |
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| Abstract | Previous animal studies have not conclusively determined the association between exposure to humidifier disinfectants (HDs) containing 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and/or 2-methyl-4-isothiazolin-3-one (MIT) and development of HD-associated lung injuries. Nonetheless, patients exposed to HDs containing only CMIT and/or MIT showed clinically similar lung injuries to those exposed to HDs containing polyhexamethylene guanidine (PHMG) or oligo (2-[2-ethoxy]ethoxyethyl) guanidinium chloride (PGH). Here, we report twin sisters with lung injuries associated with exposure to CMIT/MIT-containing HDs. At 6 months of age, a younger twin sister presented with the 3-day history of cough, sputum, and respiratory difficulty. Chest radiography revealed multiple patchy consolidation and ground-glass opacities with pneumothorax and pneumomediastinum. Thoracostomy was performed due to pneumothorax at admission and she was discharged at 11 days of hospitalization. At 5 years of age, multiple tiny nodules and faint centrilobular ground-glass opacities were observed with the small pneumatocele. The elder sister visited a tertiary hospital due to dyspnea at 12 months of age. Chest radiography showed consolidation, pneumomediastinum, and pulmonary interstitial emphysema. There was no response to the administration of immunosuppressant drugs and antifibrotic agents. At 5 years of age, chest CT revealed ground-glass opacity and multiple tiny centrilobular ground-glass opacities nodules in both lungs with exercise intolerance. |
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| AbstractList | Previous animal studies have not conclusively determined the association between exposure to humidifier disinfectants (HDs) containing 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and/or 2-methyl-4-isothiazolin-3-one (MIT) and development of HD-associated lung injuries. Nonetheless, patients exposed to HDs containing only CMIT and/or MIT showed clinically similar lung injuries to those exposed to HDs containing polyhexamethylene guanidine (PHMG) or oligo (2-[2-ethoxy]ethoxyethyl) guanidinium chloride (PGH). Here, we report twin sisters with lung injuries associated with exposure to CMIT/MIT-containing HDs. At 6 months of age, a younger twin sister presented with the 3-day history of cough, sputum, and respiratory difficulty. Chest radiography revealed multiple patchy consolidation and ground-glass opacities with pneumothorax and pneumomediastinum. Thoracostomy was performed due to pneumothorax at admission and she was discharged at 11 days of hospitalization. At 5 years of age, multiple tiny nodules and faint centrilobular ground-glass opacities were observed with the small pneumatocele. The elder sister visited a tertiary hospital due to dyspnea at 12 months of age. Chest radiography showed consolidation, pneumomediastinum, and pulmonary interstitial emphysema. There was no response to the administration of immunosuppressant drugs and antifibrotic agents. At 5 years of age, chest CT revealed ground-glass opacity and multiple tiny centrilobular ground-glass opacities nodules in both lungs with exercise intolerance.Previous animal studies have not conclusively determined the association between exposure to humidifier disinfectants (HDs) containing 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and/or 2-methyl-4-isothiazolin-3-one (MIT) and development of HD-associated lung injuries. Nonetheless, patients exposed to HDs containing only CMIT and/or MIT showed clinically similar lung injuries to those exposed to HDs containing polyhexamethylene guanidine (PHMG) or oligo (2-[2-ethoxy]ethoxyethyl) guanidinium chloride (PGH). Here, we report twin sisters with lung injuries associated with exposure to CMIT/MIT-containing HDs. At 6 months of age, a younger twin sister presented with the 3-day history of cough, sputum, and respiratory difficulty. Chest radiography revealed multiple patchy consolidation and ground-glass opacities with pneumothorax and pneumomediastinum. Thoracostomy was performed due to pneumothorax at admission and she was discharged at 11 days of hospitalization. At 5 years of age, multiple tiny nodules and faint centrilobular ground-glass opacities were observed with the small pneumatocele. The elder sister visited a tertiary hospital due to dyspnea at 12 months of age. Chest radiography showed consolidation, pneumomediastinum, and pulmonary interstitial emphysema. There was no response to the administration of immunosuppressant drugs and antifibrotic agents. At 5 years of age, chest CT revealed ground-glass opacity and multiple tiny centrilobular ground-glass opacities nodules in both lungs with exercise intolerance. Previous animal studies have not conclusively determined the association between exposure to humidifier disinfectants (HDs) containing 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and/or 2-methyl-4-isothiazolin-3-one (MIT) and development of HD-associated lung injuries. Nonetheless, patients exposed to HDs containing only CMIT and/or MIT showed clinically similar lung injuries to those exposed to HDs containing polyhexamethylene guanidine (PHMG) or oligo (2-[2-ethoxy]ethoxyethyl) guanidinium chloride (PGH). Here, we report twin sisters with lung injuries associated with exposure to CMIT/MIT-containing HDs. At 6 months of age, a younger twin sister presented with the 3-day history of cough, sputum, and respiratory difficulty. Chest radiography revealed multiple patchy consolidation and ground-glass opacities with pneumothorax and pneumomediastinum. Thoracostomy was performed due to pneumothorax at admission and she was discharged at 11 days of hospitalization. At 5 years of age, multiple tiny nodules and faint centrilobular ground-glass opacities were observed with the small pneumatocele. The elder sister visited a tertiary hospital due to dyspnea at 12 months of age. Chest radiography showed consolidation, pneumomediastinum, and pulmonary interstitial emphysema. There was no response to the administration of immunosuppressant drugs and antifibrotic agents. At 5 years of age, chest CT revealed ground-glass opacity and multiple tiny centrilobular ground-glass opacities nodules in both lungs with exercise intolerance. Previous animal studies have not conclusively determined the association between exposure to humidifier disinfectants (HDs) containing 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and/or 2-methyl-4-isothiazolin-3-one (MIT) and development of HD-associated lung injuries. Nonetheless, patients exposed to HDs containing only CMIT and/or MIT showed clinically similar lung injuries to those exposed to HDs containing polyhexamethylene guanidine (PHMG) or oligo (2-[2-ethoxy]ethoxyethyl) guanidinium chloride (PGH). Here, we report twin sisters with lung injuries associated with exposure to CMIT/MIT-containing HDs. At 6 months of age, a younger twin sister presented with the 3-day history of cough, sputum, and respiratory difficulty. Chest radiography revealed multiple patchy consolidation and ground-glass opacities with pneumothorax and pneumomediastinum. Thoracostomy was performed due to pneumothorax at admission and she was discharged at 11 days of hospitalization. At 5 years of age, multiple tiny nodules and faint centrilobular ground-glass opacities were observed with the small pneumatocele. The elder sister visited a tertiary hospital due to dyspnea at 12 months of age. Chest radiography showed consolidation, pneumomediastinum, and pulmonary interstitial emphysema. There was no response to the administration of immunosuppressant drugs and antifibrotic agents. At 5 years of age, chest CT revealed ground-glass opacity and multiple tiny centrilobular ground-glass opacities nodules in both lungs with exercise intolerance. KCI Citation Count: 0 |
| Author | Cho, Young Ah Lee, So-Yeon Park, Dong-Uk Son, Seung Kook Cho, Hyun-Ju Yang, Song-I Lee, Eun Yoon, Jisun Jung, Sungsu Do, Kyung-Hyun Hong, Soo-Jong |
| AuthorAffiliation | 6 Department of Environmental Health, Korea National Open University, Seoul, Korea 2 Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea 1 Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea 3 Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea 4 Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea 5 Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea |
| AuthorAffiliation_xml | – name: 1 Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea – name: 5 Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea – name: 4 Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea – name: 2 Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea – name: 6 Department of Environmental Health, Korea National Open University, Seoul, Korea – name: 3 Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea |
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| Cites_doi | 10.1007/s00330-015-3813-1 10.1542/peds.113.S3.984 10.1007/s00204-011-0689-y 10.1021/es300567j 10.1164/rccm.201404-0710LE 10.3345/kjp.2008.51.4.383 10.1111/ina.12126 10.2131/jts.41.711 10.1136/thoraxjnl-2013-204135 10.1016/j.toxlet.2016.11.005 10.1164/rccm.201306-1088OC 10.1016/j.scitotenv.2017.04.040 10.1111/j.1600-0536.2011.01924.x 10.1371/journal.pone.0176083 10.1007/s12012-012-9193-8 10.3346/jkms.2013.28.6.915 10.1371/journal.pone.0064430 10.1136/thx.52.8.746 10.1136/thoraxjnl-2013-204132 10.1111/ina.12180 10.4168/aair.2012.4.4.240 10.3345/kjp.2009.52.3.324 10.1371/journal.pone.0124610 10.1016/j.tiv.2014.02.004 10.1513/AnnalsATS.201504-221OC 10.1111/j.1600-0536.2012.02157.x |
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| SubjectTerms | Case Report 의학일반 |
| Title | Two Cases of Chloromethylisothiazolinone and Methylisothiazolinone-associated Toxic Lung Injury |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/29651817 https://www.proquest.com/docview/2025311446 https://pubmed.ncbi.nlm.nih.gov/PMC5897155 https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002337134 |
| Volume | 33 |
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| ispartofPNX | Journal of Korean Medical Science, 2018, 33(16), , pp.1-8 |
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